Diagnostic algorithms for non-ST-segment elevation myocardial infarction: open issues

被引：3

作者：

Clerico, Aldo ^{[1
]}

Aimo, Alberto ^{[2
,3
]}

Zaninotto, Martina ^{[4
,5
]}

Plebani, Mario ^{[4
,5
]}

机构：

[1] Fdn CNR Toscana G Monasterio, Scuola Super St Anna, Dept Lab Med, Lab Cardiovasc Endocrinol & Cell Biol, Via Trieste 41, I-56126 Pisa, Italy

[2] Scuola Super Sant Anna, Pisa, Italy

[3] Fdn CNR Reg Toscana G Monasterio, Pisa, Italy

[4] Azienda Osped Univ Padova, Dipartimento Med Lab, Padua, Italy

[5] Univ Padua, Dipartimento Med, Padua, Italy

来源：

CLINICAL CHEMISTRY AND LABORATORY MEDICINE | 2021年 / 59卷 / 11期

关键词：

cardiac troponins; cardiovascular risk; guidelines; high-sensitivity immunoassay; quality specification; reference population; HIGH-SENSITIVITY TROPONIN; 4TH UNIVERSAL DEFINITION; CARDIAC TROPONIN; 99TH PERCENTILE; RULE-OUT; GENERAL-POPULATION; CARDIOVASCULAR OUTCOMES; ANALYTICAL PERFORMANCE; RISK STRATIFICATION; EUROPEAN-SOCIETY;

D O I：

10.1515/cclm-2021-0550

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

The use of serial measurement of cardiac troponin (cTn) is recommended by international guidelines for the diagnosis of myocardial infarction (MI) since 2000. This article focuses on factors influencing temporal changes in high-sensitive cTn (hs)-cTn and the impact of these factors on the diagnosis of non-ST-segment elevation MI (NSTEMI). The recommendations proposed by three different international guidelines published in 2020-2021 for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation (NSTE) show some discrepancies. In particular, there is no agreement among these guidelines about cut-off or absolute change values to be used for the rule-in, especially regarding the use of sex-specific cut-off values. Furthermore, there are no sufficient evidences on the diagnostic accuracy and cost effectiveness related to cut-off values suggested for algorithms to be used by some hs-cTnI methods.

引用

页码：1761 / 1771

页数：11

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